SCN5A Variant L1565M Detail

We estimate the penetrance of LQTS for SCN5A L1565M around 3% and the Brugada syndrome penetrance around 10%. SCN5A L1565M was found in a total of 1 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. L1565M is present in 1 alleles in gnomAD. L1565M has been functionally characterized in 0 papers. This residue is located in a Non_Hotspot region for Brugada syndrome and a Non_Hotspot region for LQTS. In silico predictions, functional data (if available), and location in structure are equivalent to phenotyping 10 individuals for Brugada syndrome (1 diagnosed with Brugada syndrome) and 5 individuals for LQTS (0 with LQTS). These data combined with observations of carriers lead us to estimate the LQTS penetrance for SCN5A L1565M around 3% (0/11) and the Brugada syndrome penetrance around 10% (1/11).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-0.46 0.153 3.15 0.582 9 1
PROVEAN scores less than -2 are considered deleterious. REVEL scores higher than 0.5 or 0.75 are considered likely pathogenic (higher sensitivity with the former cutoff, higher specificity with the latter cutoff). A PolyPhen-2 score of 0.85 or greater is considered likely pathogenic. BLAST-PSSM reflects the evolutionary conservation of residue substitutions, more negative numbers indicate fewer observations of the specific substitution than is expected. Penetrance Density is our previously published method to calculate the average BrS/LQTS probability density in a shell of residues surrounding a residue of interest (Kroncke et al. 2019).

Reported Carrier Data

PubMed ID Year Carriers Unaffected LQT3 BrS1 Other Other Disease
LITERATURE, COHORT, AND GNOMAD: - 1 1 0 0 -
VARIANT FEATURES ALONE: - 15 14 0 1 - -
Summary totals might not agree with the literature table because of duplicate patients, which were excluded from the total counts. We do not distinguish here between multiple missense codons. Missense variants are combined across degenerate codon substitutions since codon-level data were not consistently available for curation.

L1565M has 39 previously observed neighbors within 15 angstroms

A residue within a folded protein on average has nearest neighbors that fall roughly into two shells: a "nearest" neighbor around 5-6 angstroms and a second shell around 11 angstroms. All variants shown in the rightmost column have been observed in at least one individual in the literature or gnomAD.

Neighbor Distance (Angstroms) Variants Observed in Individuals
1569 7 A1569P,
1544 12 T1544P,
1567 7 F1567L,
1538 15
1566 6
1556 15
1568 6
1602 9
1558 11
1601 14 L1601H,
1609 14 S1609W, S1609L,
1557 12 I1557V,
1562 6
1608 13
1600 14
1571 10 F1571C,
1572 11
1564 5
1570 10 p.I1570dup, p.1570_F1571insI, I1570V,
1599 12
1545 14
1626 12 R1626H, R1626P, R1626L, R1626C,
1603 11 I1603F,
1606 7 T1606I,
1560 10 L1560F,
1559 10 I1559V,
1573 14
1537 13
1565 0 L1565M,
1605 10 c.4813+5insTGGG, G1605D, c.4813+2_4813+5dupTGGG, G1605C, c.4813+3_4813+6dupGGGT,
1563 7
1541 12
1607 10
1540 14
1604 13 V1604M, c.4810+3_4810+6dupGGGT,
1622 12
1598 13 V1598A,
1561 6
1623 15 R1623Q, R1623L, c.4867delC, R1623X,